title: Post-traumatic dissection of the internal carotid artery associated with ipsilateral facial nerve paralysis: diagnostic and forensic issues.
abstract: Traumatic internal carotid artery dissection may result from a direct blow to anterolateral aspect of the neck, or an extreme extension and rotation of the neck. Traumas involved are variable ranging from high speed motor vehicle accident to trivial traumas. The most frequent presentations of carotid artery dissection are stroke, Hörner syndrome, and paralysis of a cranial nerve. Time of ischemic signs onset is very variable too, diverging from immediate to several months delay. We report the case of a 60-year-old woman, who was assaulted by a young man. Immediately, she complained of headache and posterior cervical pain. Three months later she developed a left hemifacial paralysis. MRI and MRA showed a dissection of the left internal carotid artery. The causal relationship between the trauma and the carotid artery dissection as well as forensic issues are discussed.
authors.affiliation: Clinical Forensic Medicine Unit, Hospital of Grenoble, France. Electronic address: makhloufoued@yahoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Makhlouf
authors.forename: V
authors.initials: V
authors.lastname: Scolan
authors.forename: O
authors.initials: O
authors.lastname: Detante
authors.forename: L
authors.initials: L
authors.lastname: Barret
authors.forename: F
authors.initials: F
authors.lastname: Paysant
mesh_terms: D020215:Carotid Artery, Internal, Dissection / Q000209:etiology* / Q000473:pathology; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006261:Headache / Q000209:etiology; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014754:Violence
keywords: Carotid artery dissection; Facial nerve paralysis; Medicolegal issues; Trauma